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General NPI Number Information
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NPI Number | 1497815708
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Entity Type | Organization
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Legal Business Name | RAMIN FARZAM DDS INC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 900 WILSHIRE BLVD #440
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City | SANTA MONICA
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State | CA
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Zip | 90401-1872
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Country | US
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Telephone | 310-264-5084
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Fax | 310-264-5085
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Provider Business Mailing Address
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Address Line | 900 WILSHIRE BLVD #440
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City | SANTA MONICA
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State | CA
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Zip | 90401-1872
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Country | US
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Telephone | 310-264-5084
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Fax | 310-264-5085
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. RAMIN FARZAM
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Credential | DDS
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Telephone | 310-264-5084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 45254
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License Number State | CA
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